Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01802 | Date 13/03/2019 |
| Token No | SM/18-19/2833 13/03/2019 | Serial | 023 |
| Patient Name | Mr. DEV DAS | Contact No | 8584937067 |
| Address | 5 BECHU DEY LANE | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||